Individual
DR. MELANIE SHAW NESBITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3285 HACKS CROSS RD STE 101, MEMPHIS, TN 38125-8945
(901) 759-0970
Mailing address
3285 HACKS CROSS RD STE 101, MEMPHIS, TN 38125-8945
(901) 759-0970
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019029250
IL
122300000X
Dentist
Primary
DS0000009624
TN
1223E0200X
Endodontics
DS0000009624
TN
1223P0221X
Pediatric Dentistry
DS0000009624
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1533569
—
IL
05
—
1533569
—
TN
Enumeration date
06/05/2012
Last updated
07/28/2016
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